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同源性单倍体造血干细胞移植治疗骨髓肉瘤:一项单中心回顾性研究。

Haploidentical hematopoietic stem cell transplantation for patients with myeloid sarcoma: a single center retrospective study.

机构信息

Peking University People's Hospital, Peking University Institute of Hematolo, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantationgy, National Clinical Research Center for Hematologic Disease, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China.

Department of Hematology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, China.

出版信息

Ann Hematol. 2021 Mar;100(3):799-808. doi: 10.1007/s00277-020-04383-x. Epub 2021 Jan 8.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been regarded as a potential strategy for myeloid sarcoma (MS). The previous reports focused mainly on matched sibling donor (MSD) or matched unrelated donor (MUD) transplantation. There are no reports on haploidentical HSCT (haplo-HSCT) in MS. We retrospectively reviewed 14 MS patients who underwent haplo-HSCT. All patients achieved complete donor engraftment. The median time for neutrophil engraftment and platelet engraftment were 10 (12-21) days and 18 (8-31) days. The 100-day cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) and 3-year cumulative incidence of chronic GVHD were 37.7% (95%CI, 23.2-52.1%) and 35.7% (95%CI, 22.2-49.2%). Cytomegalovirus (CMV) reactivation was documented in 86% patients, and only one patient developed CMV pneumonia. Treatment-related mortality occurred in one (7%) patient. The 1- and 3-year cumulative incidence of relapse was 21.4% (95%CI, 11.8-31.1%) and 35.7% (95%CI, 22.4-49.0%). The probability of overall survival at 1 and 3 years was 71.4% (95%CI, 51.3-99.5%) and 64.3% (95%CI, 43.5-95.0%), respectively. The probability of disease-free survival at 1 and 3 years was 71.4% (95%CI, 51.3-99.5%) and 57.1% (95%CI, 36.3-89.9%), respectively. In conclusion, haplo-HSCT is a feasible method for patients with MS who have no MSD or MUD.

摘要

异基因造血干细胞移植(allo-HSCT)已被视为髓样肉瘤(MS)的一种潜在治疗策略。之前的报告主要集中在匹配的同胞供体(MSD)或匹配的无关供体(MUD)移植上。在 MS 中尚无关于半相合 HSCT(haplo-HSCT)的报道。我们回顾性分析了 14 例接受 haplo-HSCT 的 MS 患者。所有患者均达到完全供者嵌合。中性粒细胞植入和血小板植入的中位时间分别为 10(12-21)天和 18(8-31)天。100 天累积Ⅱ-Ⅳ级急性移植物抗宿主病(GVHD)发生率和 3 年慢性 GVHD 的累积发生率分别为 37.7%(95%CI,23.2-52.1%)和 35.7%(95%CI,22.2-49.2%)。86%的患者发生巨细胞病毒(CMV)再激活,仅有 1 例患者发生 CMV 肺炎。1 例(7%)患者发生治疗相关死亡。1 年和 3 年累积复发率分别为 21.4%(95%CI,11.8-31.1%)和 35.7%(95%CI,22.4-49.0%)。1 年和 3 年总生存率分别为 71.4%(95%CI,51.3-99.5%)和 64.3%(95%CI,43.5-95.0%)。1 年和 3 年无病生存率分别为 71.4%(95%CI,51.3-99.5%)和 57.1%(95%CI,36.3-89.9%)。总之,haplo-HSCT 是 MS 患者在没有 MSD 或 MUD 情况下的一种可行治疗方法。

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